Orthopedic surgeons are preparing to launch a new registry designed to track problems with hip and knee implants across the United States in hopes of detecting potentially defective artificial joint replacement systems as early as possible.
The American Joint Replacement Registry (AJRR) is being created by the American Academy of Orthopaedic Surgeons (AAOS) and hopes to eventually cover nearly all of the 5,000 U.S. hospitals that perform joint replacement surgery.
The program will start this month in 15 hospitals, and will track basic details about the implants, the surgeons and the implant recipients. The registry will be informed when patients need revision surgery, which should give doctors an indication of how long certain implants last, and will alert them when a particular joint replacement system seems to be failing too quickly or too often.
The registry comes on the heels of a number of recent reports of problems involving defective joint replacement systems.
In August, a DePuy ASR hip implant recall was issued for about 93,000 artificial hips after it was discovered that about 12% to 13% of the individuals who received the hip implant had their device fail within five years. Many DePuy ASR lawsuits have been filed on behalf of individuals who received the implant, alleging that doctors were expressing concerns to DePuy about a higher-than-expected failure rate for the metal hip system before the recall.
Similar concerns are now being reported involving problems with Zimmer NextGen knee replacement systems, which have not been recalled. In March, a group of orthopedic surgeons released a report highlighting the risk of Zimmer NexGen knee failures, with nearly 9% of reviewed cases requiring revision surgery and 36% showing signs of the replacement knee loosening. The researchers looked at the two year results of 108 knee replacement surgeries and concluded that the Zimmer NexGen knee problems were linked to the design of the implant, and were not related to the surgeon, the surgical approach or the type of patient receiving the knee implant.
The AJRR will be designed to help identify issues with particular hip or knee replacement products much earlier. It will be the first registry of its kind in the U.S., but there are similar registries in the United Kingdom, Australia and other countries. In fact, it was the U.K. registry that first detected the high failure rates in the DePuy ASR Hip Resurfacing System and the ASR XL Acetabular System. The U.S.’s complex and expansive medical system has made it difficult to launch a similar effort.
If successful, the pilot program would begin expanding to other hospitals next year.
Plans for the registry were first announced in July 2009. It is partially funded by medical device manufacturers, some of whom sit on the registry’s board. Some experts say that the registry could save them money by detecting recalls early, potentially helping the company avoid product liability lawsuits from thousands of patients who receive the implants.
The AAOS says that in 2006 there were more than 1 million hip and knee replacement surgeries performed in the U.S. Of those, 7.5% were revision surgeries. The 77,000 procedures to replace or repair defective or poorly installed artificial hip and knee joints added $32 billion to the cost of medical care. The AAOS says that the registry costs about $20 to $25 million to launch.